Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It’s caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions.

Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It’s characterized by a daily cough and mucus (sputum) production.

Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter.

COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.

Symptoms of the Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease symptoms often don’t appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and mucus (sputum) production at least three months a year for two consecutive years.

Other signs and symptoms of the Chronic obstructive pulmonary disease may include:

  • Shortness of breath, especially during physical activities
  • Wheezing
  • Chest tightness
  • Having to clear your throat first thing in the morning, due to excess mucus in your lungs
  • A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish
  • The blueness of the lips or fingernail beds (cyanosis)
  • Frequent respiratory infections
  • Lack of energy
  • Unintended weight loss (in later stages)
  • Swelling in ankles, feet or legs

People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation and persist for at least several days.

Causes of Chronic obstructive pulmonary disease

The main cause of COPD in developed countries is tobacco smoking. In the developing world, the Chronic obstructive pulmonary disease often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes.

Only about 20 to 30 per cent of chronic smokers may develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They may be misdiagnosed as having COPD until a more thorough evaluation is performed.

How your lungs are affected

Air travels down your windpipe (trachea) and into your lungs through two large tubes (bronchi). Inside your lungs, these tubes divide many times — like the branches of a tree — into many smaller tubes (bronchioles) that end in clusters of tiny air sacs (alveoli).

The air sacs have very thin walls full of tiny blood vessels (capillaries). The oxygen in the air you inhale passes into these blood vessels and enters your bloodstream. At the same time, carbon dioxide — a gas that is a waste product of metabolism — is exhaled.

Your lungs rely on the natural elasticity of the bronchial tubes and air sacs to force air out of your body. The chronic obstructive pulmonary disease causes them to lose their elasticity and overexpand, which leaves some air trapped in your lungs when you exhale.

Causes of airway obstruction

Causes of airway obstruction include:

  • Emphysema. This lung disease causes the destruction of the fragile walls and elastic fibres of the alveoli. Small airways collapse when you exhale, impairing airflow out of your lungs.
  • Chronic bronchitis. In this condition, your bronchial tubes become inflamed and narrowed and your lungs produce more mucus, which can further block the narrowed tubes. You develop a chronic cough trying to clear your airways.

Cigarette smoke and other irritants

In the vast majority of cases, the lung damage that leads to COPD is caused by long-term cigarette smoking. But there are likely other factors at play in the development of COPD, such as a genetic susceptibility to the disease, because only about 20 to 30 per cent of smokers may develop COPD.

Other irritants can cause COPD, including cigar smoke, secondhand smoke, pipe smoke, air pollution and workplace exposure to dust, smoke or fumes.

Alpha-1-antitrypsin deficiency

In about 1 per cent of people with a Chronic obstructive pulmonary disease, the disease results from a genetic disorder that causes low levels of a protein called alpha-1-antitrypsin. Alpha-1-antitrypsin (AAT) is made in the liver and secreted into the bloodstream to help protect the lungs. Alpha-1-antitrypsin deficiency can affect the liver as well as the lungs. Damage to the lung can occur in infants and children, not only adults with long smoking histories.

For adults with COPD related to AAT deficiency, treatment options include those used for people with more-common types of COPD. In addition, some people can be treated by replacing the missing AAT protein, which may prevent further damage to the lungs.

Risk factors

Risk factors for COPD include:

  • Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large amounts of secondhand smoke.
  • People with asthma who smoke. The combination of asthma, a chronic inflammatory airway disease, and smoking increases the risk of COPD even more.
  • Occupational exposure to dust and chemicals. Long-term exposure to chemical fumes, vapours and dust in the workplace can irritate and inflame your lungs.
  • Exposure to fumes from burning fuel. In the developing world, people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes are at higher risk of developing COPD.
  • Age. COPD develops slowly over years, so most people are at least 40 years old when symptoms begin.
  • Genetics. The uncommon genetic disorder alpha-1-antitrypsin deficiency is the cause of some cases of COPD. Other genetic factors likely make certain smokers more susceptible to the disease.

Complications

The chronic obstructive pulmonary disease can cause many complications, including:

  • Respiratory infections. People with COPD are more likely to catch colds, the flu and pneumonia. Any respiratory infection can make it much more difficult to breathe and could cause further damage to lung tissue. An annual flu vaccination and regular vaccination against pneumococcal pneumonia can prevent some infections.
  • Heart problems. For reasons that aren’t fully understood, COPD can increase your risk of heart disease, including heart attack. Quitting smoking may reduce this risk.
  • Lung cancer. People with COPD have a higher risk of developing lung cancer. Quitting smoking may reduce this risk.
  • High blood pressure in lung arteries. COPD may cause high blood pressure in the arteries that bring blood to your lungs (pulmonary hypertension).
  • Depression. Difficulty breathing can keep you from doing activities that you enjoy. And dealing with serious illness can contribute to the development of depression. Talk to your doctor if you feel sad or helpless or think that you may be experiencing depression.

Prevention

Unlike some diseases, COPD has a clear cause and a clear path of prevention. The majority of cases are directly related to cigarette smoking, and the best way to prevent COPD is to never smoke — or to stop smoking now.

If you’re a longtime smoker, these simple statements may not seem so simple, especially if you’ve tried quitting — once, twice or many times before. But keep trying to quit. It’s critical to find a tobacco cessation program that can help you quit for good. It’s your best chance for preventing damage to your lungs.

Occupational exposure to chemical fumes and dust is another risk factor for COPD. If you work with this type of lung irritant, talk to your supervisor about the best ways to protect yourself, such as using the respiratory protective equipment.

Diagnosis

The chronic obstructive pulmonary disease is commonly misdiagnosed — former smokers may sometimes be told they have COPD, when in reality they may have simple deconditioning or another less common lung condition. Likewise, many people who have COPD may not be diagnosed until the disease is advanced and interventions are less effective.

To diagnose your condition, your doctor will review your signs and symptoms, discuss your family and medical history, and discuss any exposure you’ve had to lung irritants — especially cigarette smoke. Your doctor may order several tests to diagnose your condition.

Tests may include:

  • Lung (pulmonary) function tests. Pulmonary function tests measure the amount of air you can inhale and exhale, and if your lungs are delivering enough oxygen to your blood. Spirometry is the most common lung function test. During this test, you’ll be asked to blow into a large tube connected to a small machine called a spirometer. This machine measures how much air your lungs can hold and how fast you can blow the air out of your lungs. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of a disease and to monitor how well treatment is working. Spirometry often includes measurement of the effect of bronchodilator administration. Other lung function tests include measurement of lung volumes, diffusing capacity and pulse oximetry.
  • Chest X-ray. A chest X-ray can show emphysema, one of the main causes of COPD. An X-ray can also rule out other lung problems or heart failure.
  • CT scan. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPDCT scans can also be used to screen for lung cancer.
  • Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide.
  • Laboratory tests. Laboratory tests aren’t used to diagnose COPD, but they may be used to determine the cause of your symptoms or rule out other conditions. For example, laboratory tests may be used to determine if you have the genetic disorder alpha-1-antitrypsin (AAT) deficiency, which may be the cause of some cases of COPD. This test may be done if you have a family history of COPD and develop COPD at a young age, such as under age 45.

Treatment of Chronic obstructive pulmonary disease

A diagnosis of COPD is not the end of the world. Most people have mild forms of the disease for which little therapy is needed other than smoking cessation. Even for more advanced stages of a disease, effective therapy is available that can control symptoms, reduce your risk of complications and exacerbations, and improve your ability to lead an active life.

Smoking cessation

The most essential step in any treatment plan for COPD is to stop all smoking. It’s the only way to keep COPD from getting worse — which can eventually reduce your ability to breathe. But quitting smoking isn’t easy. And this task may seem particularly daunting if you’ve tried to quit and have been unsuccessful.

Talk to your doctor about nicotine replacement products and medications that might help, as well as how to handle relapses. Your doctor may also recommend a support group for people who want to quit smoking. It’s also a good idea to avoid secondhand smoke exposure whenever possible.

Medications

Doctors use several kinds of medications to treat the symptoms and complications of COPD. You may take some medications on a regular basis and others as needed.

Bronchodilators

These medications — which usually come in an inhaler — relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day or both.

Short-acting bronchodilators include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA), and ipratropium (Atrovent). The long-acting bronchodilators include tiotropium (Spiriva), salmeterol (Serevent), formoterol (Foradil, Perforomist), arformoterol (Brovana), indacaterol (Arcapta) and aclidinium (Tudorza).

Inhaled steroids

Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of the Chronic obstructive pulmonary disease. Fluticasone (Flovent HFA, Flonase, others) and budesonide (Pulmicort Flexhaler, Uceris, others) are examples of inhaled steroids.

Combination inhalers

Some medications combine bronchodilators and inhaled steroids. Salmeterol and fluticasone (Advair) and formoterol and budesonide (Symbicort) are examples of combination inhalers.

Oral steroids

For people who have a moderate or severe acute exacerbation, short courses (for example, five days) of oral corticosteroids prevent further worsening of COPD. However, long-term use of these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection.

Phosphodiesterase-4 inhibitors

A new type of medication approved for people with severe COPD and symptoms of chronic bronchitis is roflumilast (Daliresp), a phosphodiesterase-4 inhibitor. This drug decreases airway inflammation and relaxes the airways. Common side effects include diarrhoea and weight loss.

Theophylline

This very inexpensive medication may help improve breathing and prevent exacerbations. Side effects may include nausea, headache, fast heartbeat and tremor. Side effects are dose-related, and low doses are recommended.

Antibiotics

Respiratory infections, such as acute bronchitis, pneumonia and influenza, can aggravate Chronic obstructive pulmonary disease symptoms. Antibiotics help treat acute exacerbations, but they aren’t generally recommended for prevention. However, a recent study shows that the antibiotic azithromycin prevents exacerbations, but it isn’t clear whether this is due to its antibiotic effect or its anti-inflammatory properties.

Lung therapies

Doctors often use these additional therapies for people with moderate or severe COPD:

  • Oxygen therapy. If there isn’t enough oxygen in your blood, you may need supplemental oxygen. There are several devices to deliver oxygen to your lungs, including lightweight, portable units that you can take with you to run errands and get around town. Some people with COPD use oxygen only during activities or while sleeping. Others use oxygen all the time. Oxygen therapy can improve quality of life and is the only COPD therapy proven to extend life. Talk to your doctor about your needs and options.
  • Pulmonary rehabilitation program. These programs generally combine education, exercise training, nutrition advice and counselling. You’ll work with a variety of specialists, who can tailor your rehabilitation program to meet your needs. Pulmonary rehabilitation may shorten hospitalizations, increase your ability to participate in everyday activities and improve your quality of life. Talk to your doctor about a referral to a program.

Managing exacerbations

Even with ongoing treatment, you may experience times when symptoms become worse for days or weeks. This is called an acute exacerbation, and it may lead to lung failure if you don’t receive prompt treatment.

Exacerbations may be caused by a respiratory infection, air pollution or other triggers of inflammation. Whatever the cause, it’s important to seek prompt medical help if you notice a sustained increase in coughing, a change in your mucus or if you have a harder time breathing.

When exacerbations occur, you may need additional medications (such as antibiotics, steroids or both), supplemental oxygen or treatment in the hospital. Once symptoms improve, your doctor will talk with you about measures to prevent future exacerbations, such as quitting smoking, taking inhaled steroids, long-acting bronchodilators or other medications, getting your annual flu vaccine, and avoiding air pollution whenever possible.

Surgery

Surgery is an option for some people with some forms of severe emphysema who aren’t helped sufficiently by medications alone. Surgical options include:

  • Lung volume reduction surgery. In this surgery, your surgeon removes small wedges of damaged lung tissue from the upper lungs. This creates extra space in your chest cavity so that the remaining healthier lung tissue can expand and the diaphragm can work more efficiently. In some people, this surgery can improve quality of life and prolong survival.
  • Lung transplant. Lung transplantation may be an option for certain people who meet specific criteria. Transplantation can improve your ability to breathe and to be active. However, it’s a major operation that has significant risks, such as organ rejection, and it’s necessary to take lifelong immune-suppressing medications.
  • Bullectomy. Large air spaces (bullae) form in the lungs when the walls of the air sacs are destroyed. These bullae can become very large and cause breathing problems. In a bullectomy, doctors remove bullae from the lungs to help improve airflow.

Clinical trials

Lifestyle and home remedies

If you have COPD, you can take steps to feel better and slow the damage to your lungs:

  • Control your breathing. Talk to your doctor or respiratory therapist about techniques for breathing more efficiently throughout the day. Also be sure to discuss breathing positions and relaxation techniques that you can use when you’re short of breath.
  • Clear your airways. With COPD, mucus tends to collect in your air passages and can be difficult to clear. Controlled coughing, drinking plenty of water and using a humidifier may help.
  • Exercise regularly. It may seem difficult to exercise when you have trouble breathing, but regular exercise can improve your overall strength and endurance and strengthen your respiratory muscles. Discuss with your doctor which activities are appropriate for you.
  • Eat healthy foods. A healthy diet can help you maintain your strength. If you’re underweight, your doctor may recommend nutritional supplements. If you’re overweight, losing weight can significantly help your breathing, especially during times of exertion.
  • Avoid smoke and air pollution. In addition to quitting smoking, it’s important to avoid places where others smoke. Secondhand smoke may contribute to further lung damage. Other types of air pollution also can irritate your lungs.
  • See your doctor regularly. Stick to your appointment schedule, even if you’re feeling fine. It’s important to steadily monitor your lung function. And be sure to get your annual flu vaccine in the fall to help prevent infections that can worsen your COPD. Ask your doctor when you need the pneumococcal vaccine. Let your doctor know if you have worsening symptoms or you notice signs of infection.

Coping and support

Living with COPD can be a challenge — especially as it becomes harder to catch your breath. You may have to give up some activities you previously enjoyed. Your family and friends may have difficulty adjusting to some of the changes.

It can help to share your fears and feelings with your family, friends and doctor. You may also want to consider joining a support group for people with COPD. And you may benefit from counselling or medication if you feel depressed or overwhelmed.

Preparing for your appointment

If your primary care doctor suspects that you have COPD, you’ll likely be referred to a pulmonologist — a doctor who specializes in lung disorders.

What you can do

Before your appointment, you might want to write a list of answers to the following questions:

  • What symptoms are you experiencing? When did they start?
  • What makes your symptoms worse? Better?
  • Does anyone in your family have COPD?
  • Have you had any treatment for COPD? If so, what was it and did it help?
  • Have you ever taken beta blockers for your high blood pressure or heart?
  • Are you being treated for any other medical conditions?
  • What medications and supplements do you take regularly?

You might want to have a friend or family member accompany you to your appointment. Often, two sets of ears are better than one when you’re learning about a complicated medical problem, such as COPD. Take notes if this helps.

What to expect from your doctor

Your doctor may ask some of the following questions:

  • How long have you had a cough?
  • Do you get short of breath easily?
  • Have you noticed any wheezing when you breathe?
  • Do you or have you ever smoked cigarettes?
  • Would you like help in quitting?

Treatment for COPD

Treatment can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists.

Medication

Bronchodilators are medications that help relax the muscles of the airways so you can breathe easier. They’re usually taken through an inhaler. Glucocorticosteroids can be added to reduce inflammation in the airways.

To lower risk of other respiratory infections, ask your doctor if you should get a yearly flu shot, pneumococcal vaccine, and a tetanus booster that includes protection from pertussis or whooping cough.

Oxygen therapy

If your blood oxygen levels are low, you can receive oxygen through a mask or nasal prongs to help you breathe better. A portable unit can make it easier to get around.

Surgery

Surgery is reserved for severe COPD or when other treatments have failed, which is more likely when you have emphysema. One type of surgery is called bullectomy. That’s when surgeons remove large air sacs (bullae) from the lungs. Another is lung volume reduction surgery, which removes damaged lung tissue.

Lung transplant is an option in some cases.

Lifestyle changes

Certain lifestyle changes may also help alleviate your symptoms or provide relief.

These include:

  • If you smoke, quit. Your doctor can recommend appropriate products or support services.
  • Whenever possible, avoid secondhand smoke and chemical fumes.
  • Get the nutrition your body needs. Work with your doctor or dietician to create a healthy eating plan.
  • Talk to your doctor about how much exercise is safe for you.

 

MEDICATIONNormal lung tissue and lung tissue damaged by emphysema
Medication for Chronic obstructive pulmonary disease

Medications can reduce symptoms and cut down on flare-ups. It may take a bit of trial and error to find the medication and dosage that works best for you. These are some of your options:

Bronchodilators

Medicines called bronchodilators to help loosen tight muscles around your airways. They are typically taken through an inhaler or nebulizer.

Short-acting bronchodilators last from four to six hours. You only use them when you need them. For ongoing symptoms, there are long-acting versions you can use every day. They last about 12 hours.

Some bronchodilators are beta-agonists. They work by relaxing tightened muscles around the airways. Some are anticholinergics. They prevent muscle tightening and clear mucus from the lungs. Anticholinergics can also be taken with a nebulizer.

Corticosteroids

Sometimes bronchodilators are combined with inhaled glucocorticosteroids. Using the two together can reduce inflammation in the airways and lower mucus production. Corticosteroids are also available in pill form.

Phosphodiesterase-4 inhibitors

This newer medication in pill form reduces inflammation and changes mucus production. It’s generally prescribed for severe COPD.

Theophylline

This medicine eases chest tightness and shortness of breath. It may help prevent flare-ups. It’s available in pill form.

Antibiotics and antivirals

Antibiotics or antivirals may be prescribed when you develop respiratory infections.

Vaccines

COPD increases your risk of other respiratory problems. For that reason, your doctor might recommend that you get a yearly flu shot, the pneumococcal vaccine, or the whooping cough vaccine.

DIET

Diet recommendations for people with a Chronic obstructive pulmonary disease

There’s no specific diet for COPD, but a healthy diet is important for maintaining overall health. The stronger you are, the abler you’ll be to prevent complications and other health problems.

Choose a variety of nutritious foods from these groups:

  • vegetables
  • fruits
  • grains
  • protein
  • dairy

Drink plenty of fluids. Drinking six to eight 8-ounce glasses of noncaffeinated liquids a day can help keep mucus on the thin side. This may make the mucus easier to clear out. Limit caffeinated beverages because they can interfere with medications and increase water loss. If you have heart problems, you may need to drink less, so talk to your doctor.

Go easy on the salt. It retains water, which can strain to breathe.

Weight matters. It takes more energy to breathe when you have COPD, so you might need to take in more calories. If you’re overweight, your lungs and heart may have to work harder. If you’re underweight or frail, even basic body maintenance can become difficult. Overall, having COPD weakens your immune system and decreases your ability to fight off infection.

A full stomach makes it harder for your lungs to expand, leaving you short of breath. If that happens, try these remedies:

  • Clear your airways about an hour before a meal.
  • Swap three meals a day for five or six smaller meals.
  • Save fluids until the end so you feel less full during the meal.
LIVING
Living with a Chronic obstructive pulmonary disease

COPD requires lifelong disease management. That means following the advice of your healthcare team. There’s a lot you can do on your own, too.

Remember, your lungs are weakened. You’ll want to avoid anything that might overtax them or cause a flare-up.

Number one on the list of things to avoid is smoking. If you’re having trouble quitting, talk to your doctor about smoking cessation programs. Try not to be around secondhand smoke, chemical fumes, air pollution, and dust.

A little exercise each day can help you stay strong. Talk to your doctor about how much exercise is good for you.

Maintain a diet of nutritious foods. Avoid highly processed foods that are loaded with calories and salt but lack nutrients.

If you have other chronic diseases along with COPD, it is important to manage those as well, particularly diabetes and heart disease.

Clear the clutter and streamline your home so that it takes less energy to clean and do other household tasks. If you have advanced COPD, get help with daily chores.

Be prepared. Carry your emergency contact information with you and post it on your refrigerator. Include information about what medications you take, as well as the doses. Program emergency numbers into your phone.

It can be a relief to talk to others who understand. Consider joining a support group. The COPD Foundation provides a comprehensive list of organizations and resources for people living with COPD.

STAGES
What are the stages of COPD?

One measure of COPD disease is by stage. The stages are:

Stage 0 – At risk: Symptoms include coughing and noticeable mucus. You don’t actually have COPD, so treatment isn’t necessarily needed. But do heed the warning. If you smoke, stop now. It would be wise to reassess your diet and exercise routines to improve overall health. Once you have COPD, it’s not reversible or curable.

Stage 1 – Mild: At this stage, some people still don’t notice symptoms, which may include a chronic cough and increased mucus production. If you visit a doctor at this point, chances are you’ll start using a bronchodilator as needed.

Stage 2 – Moderate: Symptoms are becoming more noticeable. In addition to a cough and mucus, you may start to experience shortness of breath. You may need a long-acting bronchodilator.

Stage 3 – Severe: Symptoms become more frequent and you may have occasional flare-ups of severe symptoms. You might find that it’s difficult to function normally. Your doctor may recommend corticosteroids, other medications, or oxygen therapy.

Stage 4 – Very severe: Symptoms are progressing and it’s harder to complete everyday tasks. Flare-ups can be life-threatening. You may be a candidate for surgical treatment.

As the disease progresses, you’re more susceptible to complications, such as:

  • respiratory infections, including colds, flu, and pneumonia
  • heart problems
  • high blood pressure in lung arteries
  • lung cancer
  • depression
LUNG CANCER
Is there a connection between Chronic obstructive pulmonary disease and lung cancer?

All around the world, COPD and lung cancer are major health problems. These two diseases are linked in a number of ways.

COPD and lung cancer have several common risk factors. Smoking is the number one risk factor for both diseases. Both are more likely if you breathe secondhand smoke, or are exposed to chemicals or other fumes in the workplace.

There may be a genetic predisposition to developing both diseases. Also, the risk of developing either COPD or lung cancer increase with age.

Between 40 and 70 per cent of people with lung cancer also have COPD. 2009 study concluded that COPD is, indeed, a risk factor for lung cancer.

A 2015 study suggests they may actually be different aspects of the same disease, and that COPD could be a driving factor in lung cancer.

In some cases, people don’t learn they have COPD until they’re diagnosed with lung cancer.

Of course, having a Chronic obstructive pulmonary disease doesn’t necessarily mean you’ll get lung cancer. You do have a higher risk though. That’s another reason why, if you smoke, quitting is a good idea.

STATISTICS
COPD statistics

Worldwide, about 65 million people have moderate to severe COPD. About 12 million adults in the United States have a diagnosis of COPD. It’s estimated that 12 million more have the disease, but don’t know it yet.

Most people with the Chronic obstructive pulmonary disease are 40 years of age or older.

The majority of people with COPD are smokers or former smokers. Smoking is the most important risk factor that can be changed. Between 20 and 30 per cent of chronic smokers develop COPD.

Between 10 and 20 per cent of people with COPD have never smoked. In up to 5 per cent of people with COPD, the cause is a genetic disorder involving low levels of a protein called alpha-1-antitrypsin.

The chronic obstructive pulmonary disease is a leading cause of hospitalizations in industrialized countries. In the United States, COPD is responsible for over 700,00 hospital admissions per year and over 1.5 million emergency department visits. Among people with lung cancer, between 40 and 70 per cent also have COPD.

About 120,000 people die from COPD each year in the United States. It’s the third leading cause of death in the United States. More women than men die from COPD each year.

It is projected that the number of COPD cases will increase by more than 150 per cent from 2010 to 2030. Much of that can be attributed to an ageing population.

OUTLOOK
What’s the outlook for people with the Chronic obstructive pulmonary disease?

The chronic obstructive pulmonary disease tends to progress slowly. You may not even know you have it during the early stages.

Once you have a diagnosis, you’ll need to start seeing your doctor on a regular basis. You’ll also have to take steps to manage your condition and make the appropriate changes to your daily life.

Early symptoms can be managed, and certain lifestyle choices can help you maintain a good quality of life for some time.

As the disease progresses, symptoms can become increasingly limiting.

In severe stages of the Chronic obstructive pulmonary disease, you may not be able to care for yourself without assistance. You’re at increased risk of developing other respiratory infections, heart problems, and lung cancer. You may also be at risk of depression.

The chronic obstructive pulmonary disease generally reduces life expectancy, though the outlook varies considerably from person to person. People with COPD who never smoked may have a modest reduction in life expectancy, while former and current smokers are likely to have a larger reduction.

Besides smoking, your outlook depends on how well you respond to treatment and whether you can avoid serious complications. Your doctor is in the best position to evaluate your overall health and give you an idea of what to expect.

 

32 thoughts on “Chronic obstructive pulmonary disease

  1. Kortne Altinga says:

    I have had emphysema for about five years. I was on oxygen during the day but not at night. I could go about two hours without the oxygen, and then I need it. I had a converter in the house and oxygen tanks for when I go shopping, etc. I am 64 years old and in relatively good health. The doctor said it was caused by a combination of smoking, dust here in Vegas, and 30 years of smog in California. I believed I will always need the oxygen to breathe. I quit smoking 15 years ago. But the damage has been done. January 2017 my pulmonologist and I decided to go with natural treatment and was introduced to Green House Herbal Clinic natural organic Emphysema Herbal formula, i had a total decline of symptoms with this Emphysema Herbal formula treatment. The infections, shortness of breath, fatigue, dry cough and other symptoms has subsided. Visit Green House Herbal Clinic official website w ww . greenhouseherbalclinic .com or email herbs@ greenhouseherbalclinic. com. I have had great improvement with my over all respiration with this product and i breath very much easier, i can never be thankful enough to nature

  2. Kortne Altinga says:

    I have had emphysema for about five years. I was on oxygen during the day but not at night. I could go about two hours without the oxygen, and then I need it. I had a converter in the house and oxygen tanks for when I go shopping, etc. I am 64 years old and in relatively good health. The doctor said it was caused by a combination of smoking, dust here in Vegas, and 30 years of smog in California. I believed I will always need the oxygen to breathe. I quit smoking 15 years ago. But the damage has been done. January 2017 my pulmonologist and I decided to go with natural treatment and was introduced to Green House Herbal Clinic natural organic Emphysema Herbal formula, i had a total decline of symptoms with this Emphysema Herbal formula treatment. The infections, shortness of breath, fatigue, dry cough and other symptoms has subsided. Visit Green House Herbal Clinic official website I have had great improvement with my over all respiration with this product and i breath very much easier, i can never be thankful enough to nature

  3. Jayden Madison says:

    I found out that I have chronic obstructive pulmonary disease three years ago. I quit smoking for a few days and started back up because it seems everyone around me smokes, my boyfriend, daughters, son-in-law and it makes it so hard to truly quit and yes I know I’m slowly killing myself. I’ve been a smoker for 38 years was down to three or four cigarettes a day then started smoking like crazy again. I really do want to quit just don’t have the willpower! So if you don’t smoke now don’t ever start,because if not for this herbal remedies i bought from total cure herbal foundation i believed i should av been with my tank now, it’s no fun getting this sick and trying to fight the urge not to smoke. I hurt so bad everyday, my back and my lungs. I wake myself up at night with my wheezing. I cough all the time I cant breath when I’m laying down. I use 2 different inhalers three to four times a day and also do breathing treatments at home.But i was able to get rid of this disease totally through the means of totalcureherbalfoundation@gmail.com which i purchase from them,this herbal foundation are the only place where you can find the right herbal medicine to any diseases including COPD emphysema.

  4. Kortne Altinga says:

    I have had emphysema for about five years. I was on oxygen during the day but not at night. I could go about two hours without the oxygen, and then I need it. I had a converter in the house and oxygen tanks for when I go shopping, etc. I am 64 years old and in relatively good health. The doctor said it was caused by a combination of smoking, dust here in Vegas, and 30 years of smog in California. I believed I will always need the oxygen to breathe. I quit smoking 15 years ago. But the damage has been done. January 2017 my pulmonologist and I decided to go with natural treatment and was introduced to Green House Herbal Clinic natural organic Emphysema Herbal formula, i had a total decline of symptoms with this Emphysema Herbal formula treatment. Visit Green House Herbal Clinic official web-site ww w. greenhouseherbalclinic. com. The infections, shortness of breath, fatigue, dry cough and other symptoms has subsided.  I am very pleased with this treatment. I breath very well now and exercise regularly, sometimes i totally forget i ever had Emphysema, I am thankful to nature, the medics failed. Share with friends!!

  5. Hasley says:

    First, please always have an inhaler with you. Nothing else will be as effective and not seeking medical help could cost you your life. I have asthma and COPD, caused by smoking. I use an inhaler 1 to 2 times a day; when feeling wheezy and coughing more than usual. My father came across a forum where so people was writing about (Best Health Herbal Centre). They sell herbs supplements for different kinds of deadly diseases, so me and my family decided to give it a try. We contacted Dr linda (Best Health Herbal Centre) immediately and purchased herbal remedy for Asthma and COPD. I used the herbal remedy as instructed and It totally reversed my Asthma and COPD within 6 weeks of usage, all thanks to Best health Herbal Centre, God bless

  6. Jean Hester says:

    Standard Herbs Home your herbal remedy really helped me to cure the deadly COPD disease that almost took my life, i just want to say thank you and how much it really meant to me, i will make sure i tell the whole world about your herbal medicine, and make sure i donate some funds to your orphanage home. Thanks so much Standard Herbs Home.

  7. Levi Jasper says:

    I am 59 now. I was diagnosed with COPD in March of 2013. I had been a heavy smoker, got a cold I couldn’t get rid of, ended up in the hospital, on a ventilator. I should have known it was coming, but like most smokers, thought it would never happen to me. I don’t smoke now and never will again, but, I still want to. My life has changed drastically. I had to stop working, sold my home (couldn’t afford it without a salary),the COPD disease has kept down since diagnosed if not for the herbal formula of Total cure herbal foundation i would have been in hospital with the use oxygen managing my condition,total cure herbal foundation finally get rid of my disease with their natural herbal products in just 14 weeks of usage which i have been on other medication for ages but am really glad now that my lungs has return to it normal position.
    contact: Totalcureherbalfoundation@gmail.com
    https://totalcureherbalfou5.wixsite.com/herbal

  8. hasley says:

    First, please always have an inhaler with you. Nothing else will be as effective and not seeking medical help could cost you your life. I have asthma and COPD, caused by smoking. I use an inhaler 1 to 2 times a day; when feeling wheezy and coughing more than usual. My father came across a forum where so many people are writing about (Best Health Herbal Centre). They sell herbs supplements for different kinds of deadly diseases, so me and my family decided to give it a try. We contacted Dr linda (Best Health Herbal Centre) immediately and purchased herbal remedy for Asthma and COPD. I used the herbal remedy as instructed and It totally reversed my Asthma and COPD within 6 weeks of usage, all thanks to Best health Herbal Centre, God bless. Please check out their website for more information ww w.besthealthherbalcentre. com

  9. Evelyn Ray says:

    In April last year, i started on natural parkinsons disease herbal treatments from RICH HERBS FOUNDATION, i am happy to report this PD herbal treatment worked very effectively. My parkinson is totally under control, i had a total decline in symptoms, the tremors, shaking, stiffness, congnition and speech problems stopped. Visit rich herbs foundation official web page ww w.richherbsfoundation .com. My family are amazed at the change and rapid improvement.

  10. Corinne Barns says:

    I was not really having a problem breathing at first. My throat was burning; I thought I had strep throat. I had pain in my neck, and there was swelling around my collar bone. The first doctor I went to said he did not know why there was swelling. He gave me antibiotics and told me that if the swelling was not better to come back in two weeks. I went back in two weeks and he said he did not know what was wrong. Since I do not have insurance, I went to a hospital emergency room, and they said I have COPD, I lost touch with reality. January 2018 I started on the COPD natural herbal formula we ordered from GREEN HOUSE HERBAL CLINIC, We spoke to few people who used the treatment here in the United States and they all gave a positive response, my symptoms totally declined over a 7 weeks use of the Green House COPD disease natural herbal formula. I am now almost 70 and doing very well, the disease is totally reversed!

  11. Levi Jasper says:

    I am 59 now. I was diagnosed with COPD in March of 2013. I had been a heavy smoker, got a cold I couldn’t get rid of, ended up in the hospital, on a ventilator. I should have known it was coming, but like most smokers, thought it would never happen to me. I don’t smoke now and never will again, but, I still want to. My life has changed drastically. I had to stop working, sold my home (couldn’t afford it without a salary),the COPD disease has kept down since diagnosed if not for the herbal formula of Total cure herbal foundation i would have been in hospital with the use oxygen managing my condition,total cure herbal foundation finally get rid of my disease with their natural herbal products in just 14 weeks of usage which i have been on other medication for ages but am really glad now that my lungs has return to it normal position.
    contact: https://totalcureherbalfou5.wixsite.com/herbal/contact
    Totalcureherbalfoundation@gmail.com

  12. Joan Rhodarmer says:

    I was diagnosed with Emphysema. My symptoms included shortness of breath, dizziness, lack of oxygen to all body parts, numbness of fingers, no energy, no appetite, fatigue, and bloodshot eyes. I was living at a place that has mold and mildew in the air conditioning unit. I also smoked a pack a day for 20 years. The Pulmonologist started me on Spiriva and Advair plus nose sprays, to reduce symptoms and slow down progression but I could not tolerate them for long due to severe side effects. I decided to adopt a more natural approach and started on Emphysema Disease Natural formula from THE HERBAL GARDENS, the Emphysema natural formula immensely helped my condition, it reversed my Emphysema. My severe shortness of breath, dry cough, low energy, fatigue, chest tightness and others gradually disappeared. Visit THE HERBAL GARDENS via their official web-site ww w. Theherbalgardens. org. This Emphysema treatment has improved the quality of my life greatly, i breath much better and feel comfortable doing so. Since the procedure I enjoy walking the dog for my daily exercise. DON’T GIVE UP HOPE!!!

  13. Joan Rhodarmer says:

    I was diagnosed with Emphysema. My symptoms included shortness of breath, dizziness, lack of oxygen to all body parts, numbness of fingers, no energy, no appetite, fatigue, and bloodshot eyes. I was living at a place that has mold and mildew in the air conditioning unit. I also smoked a pack a day for 20 years. The Pulmonologist started me on Spiriva and Advair plus nose sprays, to reduce symptoms and slow down progression but I could not tolerate them for long due to severe side effects. I decided to adopt a more natural approach and started on Emphysema Disease Natural formula from THE HERBAL GARDENS, the Emphysema natural formula immensely helped my condition, it reversed my Emphysema. My severe shortness of breath, dry cough, low energy, fatigue, chest tightness and others gradually disappeared. Visit THE HERBAL GARDENS via their official web-site This Emphysema treatment has improved the quality of my life greatly, i breath much better and feel comfortable doing so. Since the procedure I enjoy walking the dog for my daily exercise. DON’T GIVE UP HOPE!!!

  14. Gomez Lila says:

    I grew up with asthma; I suffered sinus and respiratory infections my entire life. I started smoking at 16. When I was in my early 40s, my asthma was becoming increasingly worse. I was diagnosed with COPD at age 47. I am now 55. I quit smoking four years ago. The disease does not improve. My good days were far,i was scared that i wont survive it but i was so lucky to receive a herbal products from my step father who bought it while coming from South Africa for Rugby league,this herbal remedies saved me from this disease,at first it helps fight the symptoms of diseases and i was seeing good outcome,i had to use it for 13 weeks just as they Dr was prescribed and i was totally cure of asthma and COPD, (Totalcureherbalfoundation gmailcom) do not hesitate to purchase from them they deliver across worldwide to

    Ukraine & Russia Federation
    New Zealand and Australia
    CIS Countries
    USA and Northern Americans
    South American Countries
    Europian Countries
    African Countries
    Latvian Countries
    UAE & GCC Countries

  15. Josef Martindale says:

    I am a 49-year-old man. My Parkinson’s disease appeared at the age of 47. My symptoms, at the beginning, were fine tremors and rigidity with joint stiffness. My neurologist prescribed entacapone with levodopa, carbidopa, and pramipexole. I opted not to go on prescription medicines but decided on using herbs instead, October 18, 2017 after being on the herbs you recommended, i had a total recovery from Parkinson’s disease with this natural herbal formula treatment. The tremors, Shaking, Joint Stiffness has subsided. When I stumbled upon you guys, it was just pure instinct. And from that day on it has been one of the best decisions I’ve made in my life. The caring that goes into explaining what herbs work for whatever ails me is astounding. In today’s world where so many are after a quick buck, selling without care, The Herbal Garden’s staffs amplifies the difference. I’m a believer in karma, and for generations to come, this is a herbal store that will be leaving it’s footprint in this world. Visit THE HERBAL GARDENS official web site www. theherbalgardens. org A world of thanks to The Herbal Gardens!”

  16. Dr Okosun says:

    Good day My Name is Mary Robert i am her to share a great testimony of my life i was cure from COPD by a Doctor Name DR OKOSUN i have been in COPD from 5 year i saw doctor Email on the internet so i contact him and i explain to him i follow up the instruction behold 6 days later after taking the cure i went for a COPD text to my surprise it was Negative my family doctor was surprise my husband who abandon me was surprise my brother if you no that you are positive please i will advise you to contact him now and see for your self his Email is dr.okosunspellalter@gmail.com OR @yahool.com and also you can contact him on whatsapp +2349037067348

  17. Dr Okosun says:

    Good day My Name is Mary Robert i am her to share a great testimony of my life i was cure from COPD by a Doctor Name DR OKOSUN i have been in COPD from 5 year i saw doctor Email on the internet so i contact him and i explain to him i follow up the instruction behold 6 days later after taking the cure i went for a COPD text to my surprise it was Negative my family doctor was surprise my husband who abandon me was surprise my brother if you no that you are positive please i will advise you to contact him now and see for your self his Email is dr.okosunspellalter@gmail.com OR @yahool.com and also you can contact him on whatsapp +2349037067348 k

  18. Lesley Sheppard says:

    I was diagnosed with Emphysema. My symptoms included shortness of breath, dizziness, lack of oxygen to all body parts, numbness of fingers, no energy, no appetite, fatigue, and bloodshot eyes. I was living at a place that has mold and mildew in the air conditioning unit. I also smoked a pack a day for 20 years. The Pulmonologist started me on Spiriva and Advair plus nose sprays, to reduce symptoms and slow down progression but I could not tolerate them for long due to severe side effects so I opted not to go on prescription medicines but decided on using herbs instead, October 18, 2017 after being on the herbs you recommended, i had a total recovery from Emphysema disease with this natural herbal formula treatment. The shortness of breath, dizziness has subsided. When I stumbled upon you guys, it was just pure instinct. And from that day on it has been one of the best decisions I’ve made in my life. The caring that goes into explaining what herbs work for whatever ails me is astounding. In today’s world where so many are after a quick buck, selling without care, Natural Herbal Garden’s staffs amplifies the difference. I’m a believer in karma, and for generations to come, this is a herbal store that will be leaving it’s footprint in this world. Visit NATURAL HERBAL GARDENS official web site

  19. Pedro says:

    I was diagnosed with Chronic obstructive pulmonary disease (COPD) and put on Prednisolone on december 29th, 2017. I followed it 100% for a month and could not help me the way am expecting. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on Prednisolone my whole life. At that point my life messed up and began to do a lot of research. Then I found Seth COPD story (google ” How I reversed my copd with herbal remedies” ) I read that article from end to end because everything Seth was saying made absolute sense. I started using the COPD herbal remedy february this year, product of BEST HEALTH HERBAL CENTRE. There was no diet involved, no side effect which was extremely marvelous. After the first 4 weeks of usage, my shortness of breath, chest tightness and cough disappeared completely. My COPD was totally reversed after 6 weeks of usage. Now am living COPD FREE. Please folks get off drugs and help yourself by trying natural methods.

  20. Mrs Lesley Sheppard says:

    I was diagnosed with Emphysema. My symptoms included shortness of breath, dizziness, lack of oxygen to all body parts, numbness of fingers, no energy, no appetite, fatigue, and bloodshot eyes. I was living at a place that has mold and mildew in the air conditioning unit. I also smoked a pack a day for 20 years. The Pulmonologist started me on Spiriva and Advair plus nose sprays, to reduce symptoms and slow down progression but I could not tolerate them for long due to severe side effects so I opted not to go on prescription medicines but decided on using herbs instead, October 18, 2017 after being on the herbs you recommended, i had a total recovery from Emphysema disease with this natural herbal formula treatment. The shortness of breath, dizziness has subsided. When I stumbled upon you guys, it was just pure instinct. And from that day on it has been one of the best decisions I’ve made in my life. The caring that goes into explaining what herbs work for whatever ails me is astounding. In today’s world where so many are after a quick buck, selling without care, Natural Herbal Garden’s staffs amplifies the difference. I’m a believer in karma, and for generations to come, this is a herbal store that will be leaving it’s footprint in this world.

  21. Pamela Wayans says:

    I have had ASTHMA my whole life but about 7 years ago my asthma got so bad and was diagnosed of EMPHYSEMA/COPD which was most likely due to the asthma. I was on double antibiotics and steroids, still didn’t feel any better. My lungs were constantly wheezing in all four chambers, i already used Advair, Spiriva, and Albuterol in my nebulizer, they just didn’t do much. April 2016 my sister in-law told us about Rich Herbs Foundation where she ordered herbs that effectively treated her arthritis. We ordered their COPD herbal treatment after reading alot of positive reviews, i am happy to report this COPD herbal treatment reversed my lungs condition. My quality of life has greatly improved and every one of my symptoms including difficulty breathing and wheezing are gone. Their official web page is ww w. richherbsfoundation. c om. I will be 52 soon and have never been healthier!

  22. Edward Sheaver says:

    I was diagnosed with COPD 5 years ago and was taking Spiriva and Advair plus nose sprays to slow down progression. My symptoms have always been shortness of breath, and dizziness. I am a 54 year old male. the Spiriva wasn’t really working and I could not tolerate them for long due to severe side effects, so this year our family doctor started me on Natural Herbal Gardens COPD Herbal mixture, We ordered their COPD herbal treatment after reading alot of positive reviews, i am happy to report with the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 9 weeks use of the Natural Herbal Gardens COPD natural herbal formula. My COPD is totally reversed! Their official web page is www . naturalherbalgardens . com After the herbal treatment I also finally was able to give up smoking after 20 years. I ‘m thankful to nature

  23. alvaro vande says:

    I was diagnosed in early 2013 with COPD (chronic obstructive pulmonary disease) but l can now see the symptoms back 3 or 4 years earlier. I crashed and ended up in the hospital the end of February 2014. My husband would not bring me home without oxygen so a doctor there gave us one. I have had it ever since not until i found Total Cure Herbal Foundation.When we went for an appointment, after sitting around for an hour or so a COPD surviver walk by who use this herbal formula and cure her permanently,i contacted them immediately and purchased from them,i started the usage which last for 15 weeks…all the symptoms is total terminated,am fully cured of copd disease so do not hesitate to contact them on : ( https://totalcureherbalfou5.wixsite.com/herbal/contact )
    ( Totalcureherbalfoundation@gmail.com )

  24. Edward Sheaver says:

    I was diagnosed with COPD 5 years ago and was taking Spiriva and Advair plus nose sprays to slow down progression. My symptoms have always been shortness of breath, and dizziness. I am a 54 year old female. the Spiriva wasn’t really working and I could not tolerate them for long due to severe side effects, so this year our family doctor started me on Natural Herbal Gardens COPD Herbal mixture, We ordered their COPD herbal treatment after reading alot of positive reviews, i am happy to report with the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 9 weeks use of the Natural Herbal Gardens COPD natural herbal formula. My COPD is totally reversed! Their official web page is www . naturalherbalgardens . com After the herbal treatment I also finally was able to give up smoking after 20 years. I ‘m thankful to nature

  25. Kane gareth says:

    Eleven months ago I was diagnosed with chronic obstructive pulmonary disease (COPD). I have had asthma all my life. I have just been to the doctors and seen a senior nurse who has told me I no longer have this lung conditions because Total Cure Herbal Foundation has given me a good health while using their prescription. My breathing is totally great and I don’t feel I need the COPD inhaler anymore,i actually found the herbal foundation on guessbook i managed to give a try on the their herbs which totally save me from this chronic disease..Id like for you to give a try also by contacting them on
    https://totalcureherbalfou5.wixsite.com/herbal/contact Totalcureherbalfoundation@gmail.com.

  26. Vivien Macmillan says:

    I had been hospitalized for 4 years in a row all in the same month march, for shortness of breath. They thought it was asthma. The last time which was this year, they hospitalized me for a week. Which they ran lots of test and determined I have COPD. The symptoms I had were shortness of breath, tired, and coughing.There has been little if any progress in finding a cure or reliable treatment. April this year my brother In law who’s an M.D suggested I started on Natural Herbal Gardens COPD Herbal formula which eased my anxiety a bit,We ordered their COPD herbal treatment after reading alot of positive reviews, i started on natural alternative COPD DISEASE treatment from ( www. naturalherbalgardens .com ) the treatment worked very effectively, i am happy to report with the help of Natural Herbal Garden natural herbs my severe symptoms simply vanished, i feel better now, this alternative COPD disease treatment is a breakthrough.Visit Natural Herbal Gardens official website This Herbal Protocol is Incredible!!

  27. Anita Cambell says:

    I was diagnosed with emphysema in 2008, I have to be on oxygen 16 hours minimum. I have 27% lung function. I have lost count of the times that I have been hospitalized. I worked full time, but found it was getting too much for me, so i decided to find a better solution to get rid of the disease totally,during my research i came across https://totalcureherbalfou5.wixsite.com/herbal/contact Totalcureherbalfoundation@gmail.com which i purchase the products from them, the tremendous cure has successful stop this disease from progression and gradually alleviate all symptoms which including chest pressure, shorts of breath.this herbal formula really saved my life after several years of pains but now im fully cured.

  28. ryn jacop says:

    2016 I was told I had mild emphysema, and COPD. I was shocked, I had only had minor breathing problems at times. However I had smoked for 17 years when I was very young and had quit over 38 years ago, when I developed asthma. I always heard your lungs were cleared 5 years after you quit smoking,If not for total cure herbal treatment i would’ve still be at oxygen all time,the herbal remedies has terminate the the symptoms and im fully cured of this disease in only 15 weeks of usage,the ,breathing difficulty has fully relief me and i started sleeping like a baby again after the first three weeks of usage,do not hesitate to contact them on this address because the foundation has the right formula for this lung diseases :https://totalcureherbalfou5.wixsite.com/herbal/contact Totalcureherbalfoundation@gmail.com

  29. tommy parker says:

    6 months ago I was diagnosed with COPD with 55-60% lung capacity. My doctor just said all the crying , stomping your feet will not change it so just accept it and basically patted me on the back and sent me home to die. I was devastated and was afraid to do anything. I stopped riding my bike, I was afraid to do anything that would cause any exertion. It consumed my thoughts with every breath and the fear of what to expect was almost more than I could deal with. So I couldn’t get myself all time I decided to find a herbal cure online and I came acrose Doctor Itua on how he cure several people suffering from Hiv, and Herpes I gave him a call on this Number +2348149277967 also chat on whatsapp he gave me all the details about the cure i paid him for the medicine after 5 working days i receieve my herbal medicine ,I use it for two weeks that is how I get Cured and today I’m living healthy and fine I give him thanks also promise him to testify about his work,He Can also cure the following deseases..Copd,Herpes,Hiv,Hepatitis,diabetes,
    Contact…drituaherbalcenter@gmail.com

  30. Pamela Wayans says:

    I have had ASTHMA my whole life but about 7 years ago my asthma got so bad and was diagnosed of EMPHYSEMA/COPD which was most likely due to the asthma. I was on double antibiotics and steroids, still didn’t feel any better. My lungs were constantly wheezing in all four chambers, i already used Advair, Spiriva, and Albuterol in my nebulizer, they just didn’t do much. It was hell for me due to the severe difficulty breathing. April 2016 my sister in-law told us about Rich Herbs Foundation where she ordered herbs that effectively treated her arthritis. We ordered their COPD HERBAL TREATMENT after reading alot of positive reviews from other patients, i am happy to report the COPD HERBAL TREATMENT worked very effective for my lungs condition. My quality of life has greatly improved and every one of my symptoms including difficulty breathing, respiratory infections, chronic cough and wheezing has simply stopped. Visit ww w. richherbsfoundation. c om. I will be 52 soon and have never been healthier

  31. Bellin Davis says:

    God thank you for everything and I will forever be faithful to you for directing me to Dr. Uribhor and by using his herbs to heal me totally from COPD, if not for you who else would have cure me after going to different doctors, different hospitals all in the name because I want to get cure totally but nothing work out after so many years, but after taking the herbs of Dr. Uribhor, I was healed and cure totally from COPD. I contacted Doctor on his email uribhorbreezeherbalhome@gmail.com and explained everything to him about my health condition, he said I should not worry about anything that everything will be okay and he sent me the liquid herbal medicine and powder herbal medicine to me through DHL, I tracked it and it was available, after three days I received it
    and I used accordingly to the instructions given to me by Dr. Uribhor and I started using the medicines, after one week I started seeing good changes and the handwork of the medicines, I continued using the medicines with faith and I finished everything for one month, my body system change totally and I was feeling better more than before, I contacted him and tell him the changes I noticed in me, he advised I should go to hospital for checkup which I did, to God who made me, the Doctor shake my hand and say congratulations to me and I was so surprised to hear when the doctor said I am free totally from COPD and he didn’t see anything after the test, I went to other hospitals and they confirmed the same thing and I decided to watch myself for six months, now I am telling you the truth that I am cure totally and healed forever, I thank God for doing this for me and I also thank Dr. Uribhor for what he has done and I promised to tell people about him, contact him today at uribhorbreezeherbalhome@gmail.com and God in his mercies will heal you too after using his herbs.Regards from Bellin Davis and my email is bellindavisjay@gmail.com if you have any question to ask contact me through my email and for doctor email is uribhorbreezeherbalhome@gmail.com
    Website is https://uribhorbreezegreatherbalhome.wordpress.com/author/uribhorbreezegreatherbalhome/

  32. Janet Linnekin says:

    I used COPD treatment from RichHerbs Foundation that totally treated and revered my lungs condition, visit ww w. richherbsfoundation. c om. The COPD herbal protocol is a breakthrough

Leave a Reply

Your email address will not be published. Required fields are marked *